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Walkable Communities Expert Roundtable Report

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Walkable Communities Expert Roundtable Report Walkable Communities Expert Roundtable Report Association of State and Territorial Health Officials Table of Contents Table of Contents ............................................................................................................................................. 1 Introduction to ASTHO .................................................................................................................................... 2 Introduction to Walkable Communities ......................................................................................................... 4 Meeting Summary ........................................................................................................................................... 5 Expert Recommendations ............................................................................................................................... 6 Successes, Challenges, and Current Work ...................................................................................................... 8 Research Gaps and Needs for Promoting Policies and Practices ................................................................. 13 Overall Recommendations ............................................................................................................................ 15 Conclusion ...................................................................................................................................................... 16 Acknowledgments ......................................................................................................................................... 16 Appendix A: Pre‐Meeting Questions ............................................................................................................. 18 1 Introduction to ASTHO The Association of State and Territorial Health Officials (ASTHO) is the nonprofit organization representing the state and territorial public health agencies of the United States. ASTHO’s mission is to “transform public health within states and territories to help members dramatically improve health and wellness.”1 ASTHO’s membership includes the State Health Official from every state, territory, freely associated state, and the District of Columbia. ASTHO is supported by a network of 20 affiliates representing an array of state public health agency leaders. Although each affiliate represents a different program director or leader within the state and territorial health agencies, all share a common mission to promote and protect the public’s health. ASTHO’s portfolio includes a broad set of program areas, such as environmental health, infectious disease, immunization, injury prevention, preparedness, performance, chronic disease prevention, and maternal and child health. The National Prevention Strategy, released on June 1, 2011, aims to guide our nation in the most effective and achievable means for improving health and well‐being.2 The strategy prioritizes prevention by integrating recommendations and actions across multiple settings to improve health and save lives. The strategy identifies four strategic directions and seven priorities. The strategic directions provide core recommendations necessary to build a prevention‐oriented society. The priorities provide evidence‐based recommendations likely to reduce the burden of the leading causes of preventable death and illness. ASTHO is utilizing this framework within the work of the 2014‐2015 President’s Challenge on Healthy Aging, “Living Longer Better Across All Sectors,” addressing recommendations for healthy and safe community environments, empowered people (including caregivers), active living, clinical and community preventive services, injury‐ and violence‐free living, and mental and emotional well‐being.3 ASTHO also supports using a Health in All Policies (HiAP) approach, which is a collaborative approach that integrates and articulates health considerations into policymaking across sectors and at all levels to improve the health of all communities and people.4 Although the concept of HiAP is not new, the term and principles are increasingly being discussed around the country, including in new programs and task forces within health agencies. Because a multitude of factors beyond healthcare determine the health of communities, public health practitioners, researchers, and policymakers have started to look more closely at the root causes of the public health issues that modern societies face, and are beginning to identify social and environmental circumstances in community environments as substantial contributors. Community design, transportation systems, agricultural activities, access to goods and services, and safe and affordable housing are all examples of environmental conditions that have significant impacts on health. Thus, to fully address the health consequences and benefits of all public projects, policies, and programs and improve population health in the future, diverse sectors need to work together to address complex issues through a HiAP approach. ASTHO officially began working on HiAP in 2011 through a cooperative agreement from CDC’s National Center for Environmental Health.5 The project’s goal is to educate and empower state health leadership 2 to promote HiAP through convening a national steering committee and advisory group comprised of state health agency staff and partners, developing policy guides that showcase successful HiAP approaches throughout the nation and exemplary cross‐sector collaboration, and legislative tracking of HiAP‐related bills. Additional details of ASTHO’s work and current resources can be found at http://www.astho.org/Programs/HiAP/. 3 Background: Burden of Chronic Disease and Introduction to Walkable Communities Just over half (51.6%) of U.S. adults report meeting the aerobic component of the Physical Activity Guidelines for Americans (>150 minutes per week) and only a third of youth participate in the recommended amount of at least 60 minutes of physical activity daily.6 Promoting walking is a low‐cost way to promote physical activity among all ages and the key focus of “Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities.”7 Its purpose is to increase walking across the United States by calling for improved access to safe and convenient places to walk and wheelchair roll, and creating a culture that supports these activities for people of all ages and abilities. In the 2016 Annual Benchmarking Report, 8 researchers found a positive association in communities with policies supporting safe, walkable environments and improved health. Walking presents public health agencies with an important opportunity to partner with other agencies to improve conditions and create such communities. State and local leaders can help highlight the best practice examples of policies and programs that improve walking across a spectrum of urban, rural, and suburban communities. The concept of “walkable communities” stems from the theory that more livable built environments greatly benefit communities, and that walkability is a marker for livability. According to the Surgeon General’s Call to Action, improving walkability means that communities are created or enhanced to make it safe and easy to walk and that pedestrian activity is encouraged for all people. AARP defines a livable community as “one that is safe and secure, has affordable and appropriate housing and transportation options, and offers supportive community features and services.”9 Walkable and livable communities are likely to see positive impacts from a physical and mental health, social, economic, and environmental perspective. For example, integrating walking into a community’s multi‐modal transportation plan allows for more affordable and equitable transportation for all people, leading to social interaction, increasing physical fitness opportunities, and increased wellness for all. Likewise, the concept of CDC is providing 32 states with “walkability” is both focused and broad, making it a funding to work on the following challenging issue that ultimately impacts many different strategy, including at least one of types of organizations. the following sub‐strategies. Enhanced Strategy 3: Increase Recognizing its importance, CDC is currently funding physical activity access and nutrition, physical activity, and obesity strategies, focused outreach. on providing comprehensive approaches to good health and wellness in communities, supporting partnerships to Sub‐strategy 1: Create or improve community health, and focusing on preventing enhance access to places negative health outcomes, such as obesity, diabetes, and for physical activity with heart disease.10 CDC’s strategy to increase physical focus on walking combined with activity access and outreach11 is complemented by the informational outreach. goal of creating and sustaining communities with safe, Sub‐strategy 2: Design accessible walking paths and areas for both recreation streets and communities and transportation purposes. for physical activities. 4 Meeting Summary ASTHO held the Walkable Communities Expert Roundtable Meeting on March 19, 2015, in Arlington, Virginia. The agenda revolved around the following three primary goals: 1. Learn from state and local challenges and successes to achieve walkable communities. 2. Identify current areas of research that can support these challenges. 3. Identify gaps and areas for needed research to support state and local community policies to promote walking.
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